Provider Demographics
NPI:1760023311
Name:JEMB, PLLC
Entity Type:Organization
Organization Name:JEMB, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELDREDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MLADC
Authorized Official - Phone:603-200-3035
Mailing Address - Street 1:2 WASHINGTON ST STE 216
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3893
Mailing Address - Country:US
Mailing Address - Phone:603-200-3035
Mailing Address - Fax:
Practice Address - Street 1:2 WASHINGTON ST STE 216
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3893
Practice Address - Country:US
Practice Address - Phone:603-200-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty